The present invention relates in general to cardiac assist systems, and, more specifically, to an apical ring that provides an attachment point to a patient's heart for clamping an inflow conduit of a pump and for receiving a plug if the pump is no longer needed.
A heart pump system known as a left ventricular assist system (LVAS) can provide long term patient support with an implantable pump associated with an externally-worn pump control unit and batteries. The LVAS improves circulation throughout the body by assisting the left side of the heart in pumping blood. One such system is the DuraHeart® LVAS system made by Terumo Heart, Inc., of Ann Arbor, Mich. A typical LVAS system employs a centrifugal pump, an inflow conduit coupling the pump to the left ventricle, and an outflow conduit coupling the pump to the aorta. The inflow conduit may be integrally formed with a pump housing. The inflow conduit connects to the heart via an attachment cuff. An example of an inflow conduit is shown in U.S. Pat. No. 7,048,681, incorporated by reference herein in its entirety.
The apical cuff or ring is the interface and mounting element for the pump and blood inflow tube (i.e., conduit) to the apex of the left ventricle of the heart. The assist device may be mounted to the heart through a process of elevating the left ventricle out of the pericardial sac, defibrillating the heart, suturing the ring at the apex, coring through the apex inside the ring, inserting the blood inflow conduit through the cored hole, and clamping the ring onto the conduit. Thus, the apical ring may perform the functions of 1) providing a suture attachment point onto the epicardium muscle, 2) sealing against potential blood leakage from the left ventricle around or outside of the inflow conduit, 3) permitting axial and/or or rotational adjustment of the pump and inflow conduit with respect to the left ventricle during implantation, and 4) fixing the inflow conduit in a final position with respect to the left ventricle.
The apical ring may preferably be provided with a clamping mechanism to fix the inflow conduit into its final position. Because an inflow conduit may typically include a sintered outside surface, there may be significant variation in the outside diameter of the inflow conduit from unit to unit in the region which is to be clamped by the apical ring. Consequently, conventional clamps have been made with an adjustable circumference in view of the variations in the inflow conduit.
Ease of assembly, efficient implantation, and consistency of results are important in the context of cardiac surgery. It would be desirable to provide for a clamping attachment of the inflow conduit with minimal or no adjustment, with low clamping effort, and with a small dimensional profile (i.e., footprint) of the clamp mechanism and ring once it is attached to the pump and the heart.